Analysis Of The Prognosis For Early Stage Triple-negative Breast Cancer With Breast-conserving Surgery Or Mastectomy

Objective:To analyze the prognosis of patients with early stage triple-negative breast cancer（TNBC）after breast-conserving surgery（BCS）or mastectomy,so as to provide evidence for the option of surgery for early stage TNBC.Methods:1.Retrospective analysis was performed with the clinicopa-thological data of 202 patients with early stage(T_1-2N_0-1M₀)TNBC,including 90cases of BCS combined with radiotherapy and 112 cases of mastectomy.The differences in the clinicopathological factors（age,menstrual status,BMI,tumor size,lymph node metastasis,lymphovascular invasion（LVI）,histological grade and ki-67）between the patients with BCS and the patients with mastectomy were determined by chi-square test.2.Univariate survival analysis（Log-rank）and Cox regression multivariate survival analysis were performed to analyze the influence of surgical method and other clinicopathological factors on locoregional recurrence-free survival（LRRFS）,disease-free survival（DFS）and overall survival（OS）of patients.Results:1.The follow-up time was 9-117 months,with a median follow-up time of 57 months.Finally,twenty-nine patients developed recurrence and metastasis,and 23 patients died.2.When univariate survival analysis was performed,the five-year LRRFS for BCS group and mastectomy group were92.8%and 89.7%respectively（p=0.583）,and tumor size（p=0.004）,lymph node metastasis（p=0.008）,TNM stage（p=0.004）,LVI（p=0.001）and histological grade（p=0.005）were significant factors affecting the LRRFS.The five-year DFS for BCS group and mastectomy group were 88.3%and82.8%respectively（p=0.48）,and tumor size（p=0.001）,lymph node metastasis（p=0.002）,TNM stage（p=0.002）,LVI（p<0.001）,histological grade（p=0.011）and Ki-67（p=0.034）were significant factors affecting the DFS.The five-year OS for BCS group and mastectomy group were 90%and 86%respectively（p=0.441）,and tumor size（p=0.004）,lymph node metastasis（p=0.016）,TNM stage（p=0.022）,LVI（p=0.002）and histological grade（p=0.002）were significant factors affecting the DFS.3.When Cox regression multivariate survival analysis was performed,LVI（HR=3.371,P=0.022）and histological grade（HR=5.407,P=0.026）were independent risk factors for LRRFS.Tumor size（HR=3.992,P=0.031）,LVI（HR=2.714,P=0.014）and histological grade（HR=2.374,P=0.049）were independent risk factors for the DFS.Tumor size（HR=3.927,P=0.03）,lymph node metastasis（HR=2.261,P=0.048）,LVI（HR=2.914,P=0.008）and histological grade（HR=2.546,P=0.032）were independent risk factors for OS.Conclusion:BCS combined with radiotherapy does not increase the risk of recurrence for early stage TNBC,and the patients with BCS have the same outcomes compared with that of mastectomy.Tumor size,lymph node metastasis,LVI and histological grade were significant factors affecting the prognosis of early stage TNBC.